Heart attack – emergency first aid

Important: this is a brief guide to the emergency help
that can be given in the event of a heart attack or cardiac arrest before the
arrival of emergency services. It is not intended as a replacement for a first
aid or resuscitation course.

What should you do if someone has a heart attack?

A heart attack will cause severe chest pains behind the breast
bone, often radiating towards the left arm.

If someone has a cardiac arrest or
heart attack, there
may be only a few minutes to act before it is too late. It is vital to know
what to do beforehand.

We highly recommend that you do one of these courses. They are
most helpful, and it's only by learning what to do in the calm environment of a
course that you can reliably deliver care in the highly charged situation of a
cardiac arrest.

How can you tell if someone is having a heart attack?

If the person is unconscious and breathing:

Look at the patient's chest to see if it is rising and falling.
If they are breathing, place them in the recovery position, and then call for
help from the emergency services.

If the person is unconscious and not breathing:

If they're not breathing, they are in respiratory arrest and
the current advice states that in this situation, they are also likely to be in
cardiac arrest (cardiac arrest is a condition where the heart has stopped
beating effectively).

It's best to treat them as if they are in cardiac arrest,
rather than waste valuable time looking for a pulse. The latest guidelines
suggest that lay persons should not try to find a pulse. Instead, CPR should
begin immediately on anyone who is unresponsive and not breathing normally
since even a delay of just a minute or two spend looking for a pulse can have a
very substantial detrimental effect on the outcome.

If the patient is not breathing, call for help immediately,
stating that the casualty is not breathing. You should also provide
resuscitation (see below) until the patient begins to breathe or the paramedics
arrive.

If there is no breathing, the patient is in cardiac
arrest.

What help is needed?

Immediately place the palm of your hand flat on the patient's
chest just over the lower part of the sternum (breast bone) and press your hand
in a pumping motion once or twice by using the other hand. This may make the
heart beat again.

If these actions do not restore a pulse or if the subject
doesn't begin to breathe again:

call for help, stating that the casualty is having a cardiac
arrest but stay with the patient

find out if any one else present knows CPR. Clearly, use their
help if it is available

begin CPR immediately (see below)

provide immediate cardiac massage (‘pumping the chest’, see
below), and then artificial respiration.

How do I perform CPR (cardiopulmonary resuscitation)?

The aims of cardiopulmonary resuscitation are
twofold.

Firstly, to artificially pump blood out of the heart and round
the body – this is provided by the chest compressions

And secondly, to artificially blow oxygen into the lungs –
this is done by artificial respiration.

CPR is the combination of both chest compressions, to support
the heart, and artificial respiration, to support the lungs.

The recommended guidelines are that CPR should begin with 30
compressions and then two rescue breaths and then continued at 30 compressions
to two breaths.

How do I perform chest compressions?

The procedure to perform chest compressions is:

kneel by the side of the victim

place the heel of one hand in the centre of the victim’s chest
(the lower half of the sternum, or breastbone)

now place the heel of your other hand on top of the first.
Interlock your fingers together

keep your elbows straight and bring your bodyweight over your
hands to make it easier to press down vertically

press down firmly and quickly to achieve a downwards movement
of 4 to 5cm, then relax and repeat the compression. After each compression,
release all the pressure on the chest without losing contact between the hands
and the sternum

aim for a rate of compression of about 100 per minute. You can
help your timing and counting by saying out loud 'one and two and three and
four...' etc

do this 30 times, then give artificial respiration twice, and
continue this 30:2 procedure until help arrives.

How to give artificial respiration

Tilt the head back and lift up the chin.

Pinch the nostrils shut with two fingers to prevent leakage of
air.

Take a deep breath and seal your own mouth over the person's
mouth.

Breathe slowly into the person's mouth – it should take about
two seconds to adequately inflate the chest.

Do this twice.

Check to see if the chest rises as you breathe into the
patient.

If it does, enough air is being blown in.

If there is resistance, try to hold the head back further and
lift the chin again.

Repeat this procedure until help arrives or the person starts
breathing again.

Artificial respiration and CPR should both be performed at the
same time

If possible, get someone else to help – one person to perform
artificial respiration and the other to perform CPR. (This is not easily done
without prior practice and it is well worth attending sessions on CPR training
to become familiar with the technique.)

The ratio of chest compressions to breaths is 30:2 for both
one-person and two-person CPR.

Continue until the ambulance arrives or the patient gets a
pulse and starts to breathe again.

If the pulse returns and breathing begins but the person
remains unconscious, roll them gently onto their side into the recovery
position. This way mucus or vomit can get out of the mouth and will not
obstruct the patient's breathing. It also prevents the tongue from falling back
and blocking the air passage.

Make sure the patient continues breathing and has a pulse until
the ambulance arrives

If you succeed in resuscitating the person who has been taken
ill, he or she may be confused and alarmed by all the commotion. Keep the
patient warm and calm by quietly, but clearly, telling them what has
happened.

Again, it needs to be emphasised that the only way to provide
proper first aid and resuscitation is through learning the technique, then
regular practice and guidance.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.